This competing renewal for the NINR Grant (R01 NR07615),""""""""Endocrine Changes and Treatment of Conduct Problems"""""""" seeks to incorporate endocrine assessments into: 1) a Iongterm follow-up assessment of 24 months and, 2) a new evaluation of a brief booster treatment into an effectiveness study of two acute treatments for early-onset disruptive behavior disorders in young patients. The original proposal was in response to the NINR RFA, """"""""Clinical Trials: Collaborations for Nursing Research,"""""""" encouraging a link of a nurse investigator with an existing clinical trial. We took advantage of a unique opportunity to assess the effect of a behavioral intervention on hormone concentrations in a clinical trial of treatment of 6 to 11-year old boys and girls (N = 144) with chronic antisocial behavior; specifically conduct problems across one year. Treatment was conducted in either the experimental (EXP) community setting (home, school, neighborhood) or the clinic (CLIN). Services were provided by trained clinicians who administered specialized treatment protocols that address problems across participants (child, parent, teachers) and contexts (home, community). A comparison group for treatment as usual (TAU) in a community center also was included. Multiple psychosocial measures were administered. Our current RO1 added saliva gonadal and adrenal hormone concentrations and a healthy comparison (HC) group of boys. The clinical trial now proposes follow-up at 24 months post-acute treatment, a booster treatment for maintenance, and post-booster assessments until 54 months. We propose to continue measuring hormone concentrations, add measures of puberty, and add HC girls.
The aims are to examine: 1) whether treatment group influences rate of change in hormones across time, 2) whether gonadal and adrenal hormones moderate the effect of treatment (initial acute and booster) on conduct problems across time, 3) the contributions of initial hormonal, developmental, and psychological issues to conduct problems at the Iongterm follow-up, and 4) the main effects and interaction between acute treatment (COMM, CLIN, TAU) and booster intervention (Yes/No) on changes in hormone concentrations across time. Our proposed methodology of adding hormones enhances the field by addressing limitations of the few previous studies of children and conduct problems utilizing physiological measures. We anticipate that findings will contribute to further understanding of the neurophysiology of conduct problems in youth.
